BEIJING, March 27 (Xinhua) -- Every few days, Wang Jianya, a villager in Guanhaiwei Township of the city of Ningbo in eastern China, faced the exhausting task of lifting her elderly mother from her bed, transferring her to a wheelchair, and then pushing her to the village entrance to catch a ride to a hospital for a routine catheter change.
However, this grueling ordeal is a thing of the past. A caregiver now provides her mother with 25 hours of free in-home care each month, sparing them the daunting trips to the hospital.
What made this change possible is China's long-term care insurance designed to address the basic care needs of individuals who have difficulty in taking care of themselves, ranging from eating, toileting and bathing to health checkups and rehabilitation.
Since China began piloting this scheme in select regions in 2016, nearly 310 million people have enrolled, and over 3.3 million people with disabilities have benefited from the program.
On Wednesday, the Chinese government announced plans to expand the long-term care insurance system nationwide within three years. The ambitious goal is to ease the burden of care and medical costs for 45 million seniors with disabilities or dementia, as well as those unable to care for themselves due to frailty, illness or other reasons.
Experts believe that the long-term care insurance system is a vital component of China's broader social security framework and a crucial strategy to meet the challenges of its aging population.
"Following the implementation of housing provident funds and five key social insurances, namely pension, healthcare, unemployment, work injury and maternity, the establishment of a long-term care insurance system will further strengthen the social security net and help tackle the challenges posed by an aging society," said Zhang Yinghua from the Chinese Academy of Social Sciences (CASS).
LESS BURDENSOME
The long-term care insurance system ensures that individuals who undergo a disability assessment and meet the necessary criteria will receive essential care services, with their costs reimbursed. In its initial stage, the scheme focuses on individuals with severe disabilities, with plans to expand coverage to those with moderate disabilities in the future.
Across the country, local regions have experimented with a variety of creative services, all aimed at addressing the unique needs of their residents.
In Zhenjiang, located in east China's Jiangsu Province, Mr. Ban's son, who suffers from partial paralysis, can enjoy up to three free "bedridden bathing" sessions each month. During each session, a dedicated team of three caregivers, equipped with specialized tools, ensures a comfortable and dignified bathing experience for him.
"After every bath, he feels so much better, and you can see a smile on his face," Ban said.
In Nanjing, another city in Jiangsu, a therapist regularly visits 4-year-old Wenwen, who has autism, to carry out rehabilitation exercises at home. This is part of a specially designed long-term care insurance policy introduced by Nanjing to support young children with disabilities, ensuring they receive personalized care.
Long-term care insurance services not only provide better care for the disabled but also alleviate financial pressure on their families.
Zhang Lianfa, age 93, a resident of southwest China's Chongqing Municipality, is fully disabled due to Parkinson's disease and lives in a nursing home with a monthly fee of around 4,000 yuan (about 580 U.S. dollars). Thanks to the insurance system, 1,800 yuan is covered each month, reducing her out-of-pocket costs to just 2,200 yuan.
In Binzhou, east China's Shandong Province, the local government has taken the lead by including the rental of supportive assistive devices in the long-term care insurance coverage. One resident rented an electric stair climber, normally priced at 5,850 yuan. After the insurance fund covered 70 percent of the cost and the company offered a discount, the resident only needed to pay 17 yuan per month.
The funding for long-term care insurance mainly comes from medical insurance funds and local government subsidies. Through its "crowdfunding" model, long-term care insurance transforms the heavy burden on individual families into a shared societal responsibility, according to experts.
"It is this system of social mutual aid that makes long-term care insurance possible, providing timely assistance to families trapped in care-giving struggles. It also allows disabled individuals to receive the care they need and regain a life of dignity," said Zhang from the CASS.
PROMISING INDUSTRY
While providing a safety net for millions of families, long-term care insurance has also injected new momentum into the care-giving industry.
In Ningbo, Liu Jianli runs a nursing home that has seen significant growth since the introduction of long-term care insurance. The facility has expanded from one location to six, with the number of beds increasing from 450 to 940.
Liu noted that when potential clients inquire about admission, many ask whether the facility is a designated institution under long-term care insurance, as this allows them to benefit from reduced care costs via the insurance fund. As one of the first designated institutions in Ningbo, Liu's nursing home has attracted a steady stream of clients over the years.
Currently, there are 12,000 designated long-term care service institutions nationwide, employing approximately 370,000 staff members.
The insurance scheme has also given rise to a new profession, known as long-term care specialist. To support this emerging field, the Chinese government has introduced professional certifications and encourages training and skills competitions.
Born in 1999, Shi Yinping, who works for Liu, has earned her certificate as a long-term care specialist. "With long-term care insurance, the services we offer have become more standardized and professional," Shi said. "Being a long-term care specialist has also given us a greater sense of pride in our work."
The long-term care insurance system has fostered new industries and business models, such as the development, production and rental of assistive devices, as well as disability assessments, said Wang Wenjun, deputy head of the National Healthcare Security Administration, during a press conference on Thursday.
She added that during its ten-year pilot phase, long-term care insurance has driven more than 60 billion yuan in social capital investment into related industries.
One such innovation is the use of millimeter-wave radar in assessments. Evaluators place the radar devices in the homes of individuals being assessed, collecting key behavioral data over several days to help determine their level of disability.
Dai Weidong, director of the Zhejiang long-term care insurance research center in east China, said that long-term care insurance has fueled the growth of the elderly care industry, and the development of this industry will, in turn, further improve the quality of long-term care insurance services.
CHALLENGES AHEAD
The program aligns with China's broader policy goals as the country adapts to its aging population. Official statistics reveal that China's population aged 60 and above had surpassed 310 million in 2024 and is forecast to exceed 400 million by 2035.
In response, the government has introduced a range of proactive measures. These include subsidies for elderly individuals with disabilities to help cover the cost of care services. Furthermore, the minimum monthly standard for basic pensions for both urban and rural residents will rise by 20 yuan this year.
As part of its long-term strategy, long-term care insurance has been integrated into China's development blueprint for the next five years. This initiative is accompanied by plans to expand community-based elderly care services and promote home modifications to better support the elderly.
Strengthening the social security system is also a key focus in China's development goals for the next five years.
As one of the solutions, the pilot long-term care insurance system has shown initial success, but it has also brought several emerging challenges to light.
Currently, some areas focus primarily on urban residents, while the long-term care needs of people in rural areas have been overlooked, said Yu Baorong, a professor from the School of Insurance and Economics at the University of International Business and Economics in Beijing.
"As the pilot long-term care insurance expands, it is crucial to ensure coverage for all residents, both urban and rural, and establish a system that addresses the risks of the entire population," Yu said.
Given the inadequate elderly care infrastructure in rural areas, Chen Guochang, head of a nursing home in Taikang County, central China's Henan Province, and a national legislator, has suggested promoting smart elderly care services. He recommended equipping elderly individuals with devices like wristbands and emergency call buttons, allowing them to quickly alert caregivers with a single press, ensuring fast responses and home visits when needed.
To address the shortage of long-term care specialists, national legislator Zhuo Changli, who works in the domestic service industry, proposed involving more qualified housekeeping service companies in long-term care projects.
"We should encourage more companies to participate in long-term care insurance services, fully mobilize care-giving resources, expand service supply and coverage, and better meet the care-giving needs of the aging population," she said. ■
